Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Nat Rev Cancer. 2019 Dec;19(12):686-697. doi: 10.1038/s41568-019-0199-4. Epub 2019 Sep 13.
A research autopsy is a post-mortem medical procedure performed on a deceased individual with the primary goal of collecting tissue to support basic and translational research. This approach has increasingly been used to investigate the pathophysiological mechanisms of cancer evolution, metastasis and treatment resistance. In this Review, we discuss the rationale for the use of research autopsies in cancer research and provide an evidence-based discussion of the quality of post-mortem tissues compared with other types of biospecimens. We also discuss the advantages of using post-mortem tissues over other types of biospecimens, including the large amounts of tissue that can be obtained and the extent of multiregion sampling that is achievable, which is not otherwise possible in living patients. We highlight how the research autopsy has supported the identification of the clonal origins and modes of spread among metastases, the extent that selective pressures imposed by treatments cause bottlenecks leading to parallel and convergent tumour evolution, and the creation of rare tissue banks and patient-derived model systems. Finally, we comment on the future of the research autopsy as an integral component of precision medicine strategies.
研究性尸检是对已故个体进行的一种死后医学程序，主要目的是收集组织以支持基础和转化研究。这种方法已越来越多地用于研究癌症演变、转移和治疗耐药性的病理生理机制。在这篇综述中，我们讨论了在癌症研究中使用研究性尸检的基本原理，并根据循证医学的证据，对死后组织与其他类型生物标本的质量进行了讨论。我们还讨论了使用死后组织相对于其他类型生物标本的优势，包括可以获得大量组织以及可以实现多区域采样的程度，这在活体患者中是不可能的。我们强调了研究性尸检如何支持确定转移灶之间的克隆起源和传播模式、治疗施加的选择压力导致瓶颈从而导致肿瘤平行和趋同进化的程度，以及创建罕见组织库和患者衍生的模型系统。最后，我们评论了研究性尸检作为精准医疗策略的一个组成部分的未来。
